Poor understanding of gene-environment contributors to health conditions can lead the public to misinterpret that genetics alone determines health outcomes. These misunderstandings could diminish public enthusiasm about the benefits of changing behaviors to reduce risky health behaviors and for participating in genomics research due to concerns that findings might invite social stigma. A condition called podoconiosis is an excellent and concrete example to use to identify best practices for improving literacy about how genetic and environmental factors contribute to health conditions. Podoconiosis is a form of elephantiasis that is common in highland Ethiopia. The condition is caused when genetically susceptible individuals are exposed to irritant particles in volcanic soil via walking and farming barefoot. The condition can be prevented if susceptible individuals wear shoes beginning at an early age and do so consistently. The goal of the proposed project is to explore approaches and settings for improving literacy regarding gene-environment contributors to podoconiosis as a model for other preventable health conditions. Results of qualitative (e.g., observations and interviews) and quantitative activities (e.g., surveys) will be used to develop interactive learnin strategies to build youths' conceptual understanding, confidence and skills to convey information to peers, family members and other social groups about how gene-environment factors influence health. In a first step, expert- and lay-understandings of how genetics and the environment lead to health conditions will be compared to identify areas of misunderstanding that could be improved. In a second step, a survey will be conducted with 200 youth to identify the most common misunderstandings and rank them in importance as targets for the literacy-building activities. In a third step, literacy-building activities will be developed and piloted wih a sample of youth (N=30) to assess their effects on youth's: understanding of gene-environment contributors to podoconiosis, attitudes about the preventability of the condition, social distancin and other stigmatizing behaviors, and confidence to convey gene-environment concepts to others.